Posted by: Jan | May 16, 2010

Mask Tweaks

Even the most comfortable masks have problems.  I feel like the mask I’m in now (Resmed Mirage Swift LT for Her)  is pretty comfortable overall,

but there are still problems. . .

1.  Leaking:  The nasal pillow idea is a nice one.  The nasal pillows are designed to sit against (not in) your nostrils and the latex outer pillow should seal against the skin of your nostrils while the pillows send air directly into your nose. 

The theory is that you choose a nasal pillow slightly larger than your nostrils, so that there is a good seal against the skin around your nostirls. The air flow inflates the pillows and pushes them up against your nose, so they don’t have to be tightly jammed against your nose.    Unlike a face or nasal mask, however, there’s not quite the same degree of seal.  If the nasal pillows aren’t exactly the right size, or if you move around, the seal is easily broken.  A noisy, cold, and uncomfortable leak occurs. 

All of my tweaks are NOT original.  I got a lot of them from here and here, and others from the two CPAP support boards I frequent: and the Sleep Apnea Support Forum (both are linked in my sidebar). 

There are some tricks that people swear by.  Some people use latex safe (no petroleum products or alcohol) gels or lotions (like Ayr gel or Lanolin cream)  to give just enough tackiness to get a seal around each nostril.  I found that made my nasal pillows leak more, so it didn’t work for me. 

On further reading, I found one of the causes of leakage was that the nasal pillow walls don’t hold up for very long.  Someone found that by placing a rubber O-ring around the neck of each pillow, it helps the pillow stand up more firmly and seal against the nostril, like this:

It really works!   For weeks I’ve been having trouble with my left nostril leaking and this has been working great.  Now the right one is starting to go, and I will put one on the right nasal pillow tonight.  I use size small LT  pillows, and they need a 5/8 X 7/8 X3/32/ #9 O-ring.  Larger or smaller pillows will need slighly larger or smaller O-rings. 

2.  Strap riding:  The other vexatious problem I was having was with the back strap of the Swift LT for her.  This provides stability for the entire mask and is designed to sit just below the occipital bone on the back of your head.  BUT, when you move your head against the pillow, the strap, no matter how tight, shifts.  And when the strap is too tight, the nasal pillows push through your nose up like a pig snout.  That hurts!

So some friction is needed to stop the strap from slipping around.  People with long hair can tie it in a pony tail and use their own hair to hold the strap in place.  But I have short hair.  Very short hair in back. 

After trying a few suggestions, I came across a tip to put the hook side of velcro tape on the inside of the back strap.  The people who tried it used sticky-back velcro and stapled it on for added security.  YEESH!  I certainly don’t want staples anywhere near my head or bed linen.  But sewing works.  I got NON-sticky velcro (it’s a bugger to sew sticky back velcro and it ruins the sewing machine needle) and sewed it to the back strap.


It sounds like it would be uncomfortable, but it’s not.  It works very well, the strap does not shift, the pillows stay in place against my nostrils and do not leak as much. 

Oh, and one invention is mine alone.  I guess I have a small head, so the top straps were long and often getting caught and twisted when I put the mask on.  So I made little guides that hold the straps in place out of cloth.  Those are the kind of frayed things you see in the foreground. 

These are little, simple things, but they make a world of difference in my comfort and ability to tolerate this therapy.



  1. I’m so glad you are writing this blog, you have found so much useful information! And invented where you did not find.

    I could not write this blog, but I can sure cheer you on.

  2. Thanks, Gail. It really helps me work through my issues with CPAP by putting them down and getting good feedback ;o)

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